Report on performance
Performance
Re-referrals
In late 2006 Medicare Australia revised its procedures for managing concerns with practitioners who have previously been referred to PSR. The revised process means that in certain circumstances practitioners are not offered a further period of review before Medicare Australia decides to refer the case to PSR.
Implementation of this revised process saw an increase in the number of requests to PSR in 2007–08 for practitioners Medicare Australia had previously referred. The 19 cases concerned included 17 GPs and two other medical practitioners, who have collectively been referred to PSR 25 times. These cases had previously resulted in four decisions to take no further action, six negotiated agreements and 15 Committee findings of inappropriate practice. Sanctions included reprimand by the Director, repayment of Medicare benefits of between $9000 and $316,373, and full or partial disqualification from Medicare for from one month to one year.
The 19 cases received in 2007–08 have resulted in one decision to take no further action, seven negotiated agreements and six referrals to Committees. At 30 June 2008 five cases were still under review.
PSR is working with Medicare Australia to analyse the claiming behaviour of practitioners whose practice continues to cause concern after they have been through the PSR process.